The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis

Prokopidis K, Moriarty F, Bahat G, McLean J, Church DD, Patel HP · Journal of Cachexia, Sarcopenia and Muscle

Null across every pooled muscle measure. NMN did not change skeletal muscle index (mean difference -0.42, 95% CI -0.99 to 0.14, I-squared 63 percent, p=0.14), handgrip strength on either side (0.61, -0.89 to 2.10 left; 0.45, -1.06 to 1.96 right; both I-squared 0 percent), gait speed (-0.01, -0.08 to 0.06, I-squared 0 percent, p=0.79) or the five-time chair stand test (-0.21, -0.70 to 0.29, p=0.41). The narrative synthesis adds no improvement in knee extension strength, the short physical performance battery or thigh muscle mass. Nicotinamide riboside at 1 g/day did not improve grip at three, six or ten weeks; its one positive is a longer six-minute walk in peripheral artery disease, 22.4 m at three months and a 17.6 m between-group difference at six. In mild cognitive impairment the chair stand was slower and the physical performance battery lower on nicotinamide riboside. The conclusion is that current evidence does not support either precursor for preserving muscle mass or function past age 60.

Population

Randomised placebo-controlled trials of NMN or nicotinamide riboside in adults with mean ages from 60.9 to 83 years

Intervention

Oral NMN or nicotinamide riboside

Comparator

Placebo

Limitations

Few trials per outcome, three to five in most pools, so the confidence intervals are wide enough to hide a small effect. Sensitivity analyses excluding diabetic and prediabetic cohorts and high-risk-of-bias trials did not change the picture. Muscle is not cartilage, and no trial here measured a joint.